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Follow-Up Consultations for Cervical Cancer Patients in a Mexican Cancer Center. Comparison with NCCN Guidelines

  • Serrano-Olvera, Alberto (Divison of Clinical Research, Instituto de Investigaciones Biomedicas, UNAM, Instituto Nacional de Cancerologia) ;
  • Cetina, Lucely (Divison of Clinical Research, Instituto de Investigaciones Biomedicas, UNAM, Instituto Nacional de Cancerologia) ;
  • Coronel, Jaime (Divison of Clinical Research, Instituto de Investigaciones Biomedicas, UNAM, Instituto Nacional de Cancerologia) ;
  • Duenas-Gonzalez, Alfonso (Unit of Biomedical Research on Cancer, Instituto de Investigaciones Biomedicas, UNAM, Instituto Nacional de Cancerologia)
  • Published : 2014.11.06

Abstract

Purpose: This study aimed to determine the patterns of follow-up visits for cervix cancer in a national cancer center in Mexico. Materials and Methods: The National Cancer Institute of Mexico is cancer center with 119 beds that mostly cares for an underserved and socially disadvantaged population. The medical records of cases of cervical cancer that had at least one year of clinical follow-up after being in complete response at the end of primary treatment were analyzed. We recorded the numbers of total and yearly follow-up visits and these were compared with the number of follow-up visits recommended by the National Comprehensive Cancer Network 2013, version 2 for cervical cancer. Results: Between March and June 2007, the medical records of 96 consecutive patients were reviewed. Twenty (21%) of these met inclusion criteria and were selected. In the first year the median number of visits was 11 (4-20). In the ensuing years, $2^{nd}$, $3^{rd}$, $4^{th}$ and $5^{th}$, the number of analyzed patients remaining in follow-up decreased to 17, 14, 13 and 9 respectively. There were 462 follow-up visits to primary treating services (Gynecology Oncology, Radiation Oncology and Medical Oncology) as compared to 220 suggested by the NCCN guidelines ($X^2$ test p<0.0001). There were 150 additional visits to other services. Conclusions: Our results suggest that in our institution there is an overuse of oncological services by cervical cancer patients once treatment is completed.

Keywords

Cervix cancer;follow-up;medical visit;overuse

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